We reported on a pediatric case of post-traumatic osteolysis of the distal clavicle, which has not previously been reported. A seven-year-old boy had a Nuss operation (insertion of convex steel bars under the sternum) for the correction of pectus excavatum. After two years, he had revision surgery because of unsatisfactory results. One week later, he had had an uncomfortable feeling around his right clavicle and it developed into pain with swelling. Six months after the second surgery, we observed osteolysis of the right distal clavicle on a plain radiograph. A bone scan showed hot spots not only in the same region but also in the right sternoclavicular joint. Spontaneous healing of the osteolysis began to be seen on plain radiographs 9 months after the surgery and it was completed at 2 years after surgery. We supposed that an acute anterior shift of the sternum due to Nuss operation affected the acromioclavicular joint as a trauma changing the alignment of the joint and the osteolysis of the distal clavicle arose from this trauma. We retrospectively reviewed the plain chest radiographs including clavicles of 19 children who had Nuss operation but we did not find any lesions. Post traumatic osteolysis of the distal clavicle in children has not previously been reported on and the spontaneous radiological healing of this disease has not been reported on even in adults. This case proposed that we use the conservative treatment for osteolysis of the distal clavicle in children.
